Authors

Understanding Insurance Coverage Policies for Incretin Mimetics for Weight Management

The high cost of incretin mimetics for weight management limits insurance coverage and potentiates variation in utilization management strategies to control near-term spending.

Pharmacist-Led Review of Empagliflozin and Ertugliflozin Following Formulary Update

Management of empagliflozin and ertugliflozin may be suboptimal following an insurance carrier’s formulary updates. Pharmacists may improve the management.

Managing Total Knee Replacement Under Value-Based Payments

This article describes the approach that a large primary care group at risk for value-based payments chose to deploy in managing clinical and financial outcomes of knee osteoarthritis jointly with orthopedic surgeons.

Improving Glycemic Control in Diabetes Through Virtual Interdisciplinary Rounds

Patients with diabetes whose providers received advice from remote, virtual interdisciplinary rounds had a greater 1-year reduction in hemoglobin A1c than comparable patients.

Pharmacogenomics for Improved Outcomes and Decreased Costs in Health Care

Economic Burden of Osteoporotic Fractures: The Tip of the Iceberg?

The economic burden of osteoporotic fractures may be much higher than estimated: just the tip of the iceberg. In this letter, we suggest that the cost of these fractures might be underestimated by considering only direct medical cost.

Hospitals’ Strategies to Reduce Costs and Improve Quality: Survey of Hospital Leaders

Hospitals pursue a broad range of efforts to improve quality, with those participating in bundled payments attempting to reduce postacute care to a greater degree than nonparticipants.

Using a Brief Tool to Assess Healthy School Environments: A Pilot Study

The authors evaluated a brief assessment tool that accountable care organizations can use to help elementary schools improve student nutrition and increase physical activity.

Dual-Eligible Beneficiaries’ Grocery Supplemental Benefit Use and Health Care Utilization

Medicare Advantage grocery supplemental benefit use is associated with increased outpatient care, suggesting that policy changes allowing for nonmedical supplemental benefits could improve beneficiaries’ health, especially for dual-eligible beneficiaries.

Timely Preterm-Birth Prediction Among Pregnant Women in Medicaid Without Preterm-Birth History

A novel prediction model is developed that accurately predicts preterm birth in a timely manner among pregnant women in Medicaid without preterm-birth history.

How English- and Spanish-Preferring Patients With Cancer Decide on Emergency Care

Care delivery innovations to help patients with cancer avoid emergency department visits are underused. The authors interviewed English- and Spanish-preferring patients at 2 diverse health systems to understand why.

Social Determinants of Health and High-Cost Utilization Among Commercially Insured Population

Residence in a more disadvantaged neighborhood was associated with higher likelihood of being a high-cost utilizer among older adults and lower likelihood among younger adults.

Impact of Food Affordability on Diabetes-Related Preventable Hospitalization

Medicaid enrollees residing in counties with greater food affordability had lower odds of preventable hospitalization related to diabetes.

Evaluation of a Pediatric Asthma High-risk Scoring Algorithm

An asthma risk score using 7 clinically relevant parameters evaluated in a pediatric Medicaid managed care population can stratify risk for following-year asthma hospitalization.

Operating Room Efficiency of Orthopedic Surgery During the COVID-19 Era

The authors analyzed the impacts of COVID-19 on orthopedic operating room efficiency via comparison of 14,856 surgeries performed before, during, and after the pandemic.

Clinician-Identified Health Characteristics and Palliative Care Eligibility: Is Dementia Overlooked?

Clinicians may underassess the need for community-based palliative care among patients with dementia.

Choosing Wisely Interventions to Reduce Antibiotic Overuse in the Safety Net

This study evaluates the impact of Choosing Wisely–based interventions on antibiotic prescribing for viral respiratory tract infections in a real-world safety-net setting.

Evaluation of Biosimilar Trastuzumab MYL-1401O in HER2-Positive Breast Cancer

The authors evaluate the effect and safety of biosimilar trastuzumab MYL-1401O in human epidermal growth factor receptor 2 (HER2)–positive early-stage (neoadjuvant and adjuvant therapy) and metastatic (palliative therapy) breast cancer using real-world data.

Reflecting on Global Pulmonary Medicine Insights at ATS 2025

Attendees at the American Thoracic Society (ATS) 2025 International Conference highlight global networking, scientific advancements, and professional development at this year's meeting.

Predicting Drug-Drug and Drug-Gene Interactions in a Community Pharmacy Population

The probability of drug interactions increases when genetic polymorphisms are considered, indicating that pharmacogenetic assessment may be useful in predicting the presence and severity of interactions.

Telemedicine Catches On: Changes in the Utilization of Telemedicine Services During the COVID-19 Pandemic

This analysis of health insurance claims data demonstrates rapid increase and sustained high utilization of telemedicine services during the COVID-19 pandemic.

An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19

For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.

Hospitals’ Strategies to Reduce Costs and Improve Quality: Survey of Hospital Leaders

Hospitals pursue a broad range of efforts to improve quality, with those participating in bundled payments attempting to reduce postacute care to a greater degree than nonparticipants.

Hospital Stays and Probable Dementia as Predictors of Relocation to Long-Term Care Facilities

This article explores late-life relocations in patients with dementia, hospital stays, and their implications for health care policy, geriatric care, and future research priorities.

A Scoping Review of US Insurers’ Use of Patient-Reported Outcomes

This scoping review found 350 articles that discuss US health insurance providers’ use of patient-reported outcomes about health-related quality of life.

Contributor: Providers and Patients Push Back, Payers Push Forward—Co-pay Mitigation Programs

Research shows how commercial health plans impact payer trends in the co-pay landscape and provides key areas that pharmaceutical and biotech manufacturers can explore to ensure patient access.

Predictors of Discharge From the VA Caregiver Support Program

The year of application predicts discharge from the Department of Veterans Affairs (VA) caregiver program. Unexpected, disallowed criteria also predict discharge, with significant others facing higher discharge risk than spouses.

Participating Faculty: Suprachoroidal Triamcinolone Acetonide Injectable Suspension for Macular Edema Associated With Noninfectious Uveitis: An In-Depth Look at Efficacy and Safety

Diagnosis and Management of TRK Fusion Cancer

Preferences for and Experiences With Pill Appearance Changes: National Surveys of Patients and Pharmacists

Changes in generic drug appearance occur often. Patients’ and pharmacists’ responses to those changes vary, with some patients stopping their medication or using it less.